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Jan 8, 2009 11:37AM
Jan 8, 2009 11:49AM
I feel like hope was taken from me. What if this drug could save me from getting another tumor?
Might I just add my understanding of years 5-10 (some extend to 5-15) from diagnosis in ER+ breast cancer and recurrence risk. If you search around a little bit (key words, estrogen positive breast cancer, recurrence risk, years 5-10) you will find comments from breast cancer experts.
Having done this on more than one occasion, I share with you that most oncologists now express concern that a recurrence risk does exist during years 5-10 years from diagnosis, even with past hormonal treatment the first five years. For node negative ER+ patients, the 5 to 10 year risk I've seen is 2% per year, or 10% over 5 years. For someone like myself, who was node + with ER+ breast cancer, the risk of recurrence in years 5-10 post diagnosis is 4% per year or total 20% over the second 5 years. Please note that recurrence may be local, regional, contralateral or distant. Distant recurrence risk is 0.9% per year as I recall (MA-17 data, Paul E. Goss), which is greater than the risk for which Tamoxifen was approved in high risk women for the STAR trial (risk 0.6%). Hence, many oncologists and patients are aware that estrogen sensitive breast cancer poses a longer risk of recurrence than non-estrogen sensitive breast cancer. This is very unfortunate: the "long life of ER+ breast cancer" as I refer to it. While it is true that studies are pending on continued hormone use past the initial prescribed 5 years, I believe it reasonable to say many oncologists feel a patient should at least be given full disclosure of ongoing risk, so she or he may weigh in with their opinions and perhaps choice on continuing or not.
Emanresu, with two ER+ cancers in your history, you are being very reasonable in asking if continued hormone therapy against the cancers is valid, even in years 5 to 10. I surely would wish to continue on with some hormonal treatment, especially given that it's equally fair to say we don't know that continued treatment will harm you, the corollary being that suggestion and statistics show continuation may help keep the ER+ cancer at bay. We've had women in this situation here on this board before, some in the British National Health Service, and with second opinions and their own research, they have reported back success in receipt of a prescription. In the US, an oncologist would be hard pressed not to give a two time survivor of ER+ breast cancer a prescription for hormonal therapy for years 5 to 10 if desired.
If desired I will cite references for this. I know this was just written about in Cancer, Journal of the American Cancer Society. Many internists are not aware of these statistics, btw, so please take some time to mention them to your internists who increasingly will be faced with the main followup of breast cancer patients after the initial years, due to the inadequate numbers of US oncologists in light of the aging population.
Press on, should you wish.
It cannot be emphasized too strongly that treatment of each patient is a highly individualized matter. (FDA-approved labeling for warfarin (Coumadin) NDA 9-218/5-105)